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Ureteroscopy and holmium: YAG laser lithotripsy as emergency treatment for acute renal failure caused by impacted ureteral calculi.
Urology. 2008 Sep; 72(3):504-7.U

Abstract

OBJECTIVES

To present our clinical outcomes in managing acute renal failure caused by impacted ureteral calculi with ureteroscopy and holmium: yttrium-aluminum-garnet laser lithotripsy as emergency treatment.

METHODS

A series of 27 patients with acute postrenal failure were treated from November 2002 to December 2005. Impacted calculi were located in bilateral ureters in 22 patients and unilateral ureters in 5 patients with a solitary or single functioning kidney. Acute renal failure was demonstrated with oliguria or anuria and a significant increase in serum creatinine and blood urea nitrogen. Patients were treated emergently with ureteroscopy and holmium:yttrium-aluminum-garnet laser lithotripsy in the hospital within 24 hours. Ureteral stenting was performed in all cases. Postoperative renal function, electrolytes, and urine volume were monitored daily for 7 days. Radiography and/or ultrasonography were performed at a follow-up visit in 4 weeks.

RESULTS

Ureteroscopy and laser lithotripsy were successfully performed in all patients. The mean operative time was 29.2 minutes (range 15-60). The successful fragmentation rate in the ureteroscopic procedure was 93.9% (46 of 49), and the overall stone-free rate was 88.9% (24 of 27). Shock wave lithotripsy was used in 3 patients after recovery of renal function. Of the 27 patients, 26 (96.3%) returned to normal renal function within 7 days. One patient (3.7%) had significant improvement of renal function, but it had not returned to normal at 12 weeks of follow-up. No intraoperative complications or postoperative ureteral stricture occurred.

CONCLUSIONS

Emergency ureteroscopy and holmium: yttrium-aluminum-garnet laser lithotripsy can be safely and successfully performed by skilled endourologists for acute renal failure caused by impacted ureteral calculi.

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Authors+Show Affiliations

Jiang H
Department of Urology, Huashan Hospital, Fudan University, Shanghai, People's Republic of China. haowenj@yahoo.com
Wu Z
No affiliation info available
Ding Q
No affiliation info available

MeSH

AdultAgedAluminumAnuriaCreatinineFemaleHolmiumHumansLithotripsy, LaserMaleMiddle AgedOliguriaRenal InsufficiencyUreteral CalculiUreteroscopyYttrium

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18653216

Citation

Jiang, Haowen, et al. "Ureteroscopy and Holmium: YAG Laser Lithotripsy as Emergency Treatment for Acute Renal Failure Caused By Impacted Ureteral Calculi." Urology, vol. 72, no. 3, 2008, pp. 504-7.
Jiang H, Wu Z, Ding Q. Ureteroscopy and holmium: YAG laser lithotripsy as emergency treatment for acute renal failure caused by impacted ureteral calculi. Urology. 2008;72(3):504-7.
Jiang, H., Wu, Z., & Ding, Q. (2008). Ureteroscopy and holmium: YAG laser lithotripsy as emergency treatment for acute renal failure caused by impacted ureteral calculi. Urology, 72(3), 504-7. https://doi.org/10.1016/j.urology.2008.05.041
Jiang H, Wu Z, Ding Q. Ureteroscopy and Holmium: YAG Laser Lithotripsy as Emergency Treatment for Acute Renal Failure Caused By Impacted Ureteral Calculi. Urology. 2008;72(3):504-7. PubMed PMID: 18653216.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ureteroscopy and holmium: YAG laser lithotripsy as emergency treatment for acute renal failure caused by impacted ureteral calculi. AU - Jiang,Haowen, AU - Wu,Zhong, AU - Ding,Qiang, Y1 - 2008/07/23/ PY - 2007/02/24/received PY - 2008/04/24/revised PY - 2008/05/13/accepted PY - 2008/7/26/pubmed PY - 2008/9/26/medline PY - 2008/7/26/entrez SP - 504 EP - 7 JF - Urology JO - Urology VL - 72 IS - 3 N2 - OBJECTIVES: To present our clinical outcomes in managing acute renal failure caused by impacted ureteral calculi with ureteroscopy and holmium: yttrium-aluminum-garnet laser lithotripsy as emergency treatment. METHODS: A series of 27 patients with acute postrenal failure were treated from November 2002 to December 2005. Impacted calculi were located in bilateral ureters in 22 patients and unilateral ureters in 5 patients with a solitary or single functioning kidney. Acute renal failure was demonstrated with oliguria or anuria and a significant increase in serum creatinine and blood urea nitrogen. Patients were treated emergently with ureteroscopy and holmium:yttrium-aluminum-garnet laser lithotripsy in the hospital within 24 hours. Ureteral stenting was performed in all cases. Postoperative renal function, electrolytes, and urine volume were monitored daily for 7 days. Radiography and/or ultrasonography were performed at a follow-up visit in 4 weeks. RESULTS: Ureteroscopy and laser lithotripsy were successfully performed in all patients. The mean operative time was 29.2 minutes (range 15-60). The successful fragmentation rate in the ureteroscopic procedure was 93.9% (46 of 49), and the overall stone-free rate was 88.9% (24 of 27). Shock wave lithotripsy was used in 3 patients after recovery of renal function. Of the 27 patients, 26 (96.3%) returned to normal renal function within 7 days. One patient (3.7%) had significant improvement of renal function, but it had not returned to normal at 12 weeks of follow-up. No intraoperative complications or postoperative ureteral stricture occurred. CONCLUSIONS: Emergency ureteroscopy and holmium: yttrium-aluminum-garnet laser lithotripsy can be safely and successfully performed by skilled endourologists for acute renal failure caused by impacted ureteral calculi. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/18653216/Ureteroscopy_and_holmium:_YAG_laser_lithotripsy_as_emergency_treatment_for_acute_renal_failure_caused_by_impacted_ureteral_calculi_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(08)00719-X DB - PRIME DP - Unbound Medicine ER -